PASSPORT SPECIAL FORM NO. S.L. NO.
DATE.

                                                                                                

APPENDIX ‘A’

APPLICATION FOR INDIA-BANGLADESH

PASSPORT

  1. Full Name of the applicant
    (in block letter) :-
  2. Permanent Address in full :-
  3. Name of Father/Husband :-
  4. If the applicant in a minor, name nationality & address of Guardian & his relationship with the applicant :-
  5. Nationality :-
  6. Profession/Occupation (give details) :-
  7. Place of Birth (also indicate District
    Tahasil & State) :-
  8. Date of Birth
       Date :  
       
    		  Month : 
     
    		   Year :   
           

     

  9. Descriptive Particulars :
    1. Height ___ ft ___inch.
    2. Colour of Hair ______ .
    3. Colour of Eyes ______ .
    4. Visible distinguishing Mark :

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  1. Purpose of Visit :-
  2. The following of my children below 15 years of age may accompany me :

Sl. No.         Name of Children                  Date of birth               Sex

1.

2.

3.

  1. I have not previously hold or applied for any passport myself or of my children including in para 11. My previous passport(s) has/have been surrendered to ______ my previous passport it at ached herewith strike our whichever is not applicable. I have not other application for passport since the attached passport/passports was/were issued to my or minor child in para 14.

  2. I solemnly declare that all the facts stated in this application is true to the best of my knowledge and belief. Should any of declarations made or facts stated in this application be found to be untrue, I rendered myself liable to precaution should at the discretion of the Government of India be liable to revoked and impound.

 

 

Place :

Date : Signature or left thumb impression

of the applicant.

 

In case of minor applicant only :-

I hereby accept full responsibility for the correctness the statement made above.

Signature or left thumb impression

of the Guardian .

 

___________________________________

Specimen Signature of the applicant

___________________________________

Specimen Signature of the applicant

___________________________________

___________________________________

Specimen Signature of the applicant

 

___________________________________

 

 

INSTRUCTIONS FOR INDO-BANGLADESH PASSPORT

  1. Passport application forms and challans are given to the applicants free of cost from the General Admn. (Political) Deptt.

  2. The applicants are required to submit the following documents along-with duly filled in application forms:-

    1. Challan of Rs. 200/- per case.

    2. 3(three) copies passport size photographs duly attested by a Gazetted Officer on back side.

    3. 1 (one) copy of Citizenship Certificate duly attested by a Gazetted Officer.

    4. No-objection Certificate in original, if the applicant is a Govt. employee.

    5. Old Passport, if any.

  3. After the application is submitted in proper manner the following actions are taken from the General Administration(Political) Deptt. :-

    a ) The case is sent to the SP(DIB) of the concerned District for police verification report about the applicant.

    b) The case is sent to the concerned issuing authority of the Citizenship Registration Certificate for obtaining report about the genuineness of the CRC. Verification report is necessary for the CRCs issued after March, 1971.

  4. If all the reports are found favorable, Passport is issued within a fortnight from the date of receiving verification reports.

  5. The issuing authority for India-Bangladesh Passports is the Under Secretary to the Govt. of Tripura, General Administration(Political) Deptt.